Tying with Latvia, it lost only to the Federated States of Micronesia (36.9%), Tonga (37.5%) and Timor-Leste (50.6%) and Papua New Guinea (52.1%) in this area.

This was despite a surprisingly low annual cigarette consumption, which showed that Malaysians smoked an average of 539 sticks a year.

In comparison, its regional neighbours Thailand, Singapore, The Philippines and Indonesia recorded an annual cigarette use of 560, 547, 838 and 1,085 cigarettes respectively a year.

The report said: “Boys begin smoking during their youth in response to peer pressure, misconceptions that smoking is cool or enhances popularity, easy access to tobacco products, cigarette pricing, and tobacco marketing.”

It added that tobacco marketing and the low price of cigarettes contributed to youths smoking .

At the same time, the study also showed that 4.2% of girls aged between 13 and 15 smoked.

It was also revealed that 45.6% of men and 2.4% of women in Malaysia smoked.

This was also despite Malaysia having relatively high cigarette prices, amounting to approximately US$3.30 per a box of 20 sticks, compared to Indonesia’s US$1.40 and Thailand’s US$2.56. In Singapore, a box of twenty can fetch as much as US$9.29.

At the same time, Malaysia also seemed to have a low excise tax level, recorded at 47.5%. Indonesia, The Philippines, Singapore and Thailand had excise tax levels of 45.7%, 52%, 60.7% and 62.2% respectively.

The report said: “Youth, minorities, and low-income smokers are more likely than others to quit or smoke less in response to cigarette price increases.”

The study was published by the American Cancer Society in 2012.

Malaysia currently has stiff penalties for people who sell cigarettes to minors (18 is the legal smoking age). Those found selling smokes to children risk a RM10,000 fine and risk a two-year jail term.

The government also introduced graphic images as part of the packaging and labels slapped on cigarette boxes, showing the effects of miscarriages, gangrene and other conditions; all linked to smoking.

The minimum number of cigarettes that can be sold in a box is twenty; a measure aimed at discouraging students from buying.

It has also stepped up its “Tak Nak” anti-smoking campaign, complete with billboards, advertisements and various other means.

With all these in tow, it is not known how much of an effect they really have on Malaysia’s youth.